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The Dynamics of the Dutch Health Care System--A Discourse Analysis

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  • Kor Grit
  • Wilfred Dolfsma

Abstract

In this article, we analyze recent dynamics of the Dutch health care sector, a hybrid system of public, private and professional elements, in terms of clashing discourses. Although these elements are intricately interwoven, this does not mean that the system is stable. Most notably, since the eighties the introduction of more market elements in the health care system has been widely debated. Hospitals introduced different methods commonly used in businesses, for instance. The position of managers in the institutions of health care has become more central. A discourse analysis shows the concomitant patterns of institutional change in the health care sector. We distinguish four different discourses concerning health care: economic, political, medical-professional and caring discourses. These different discourses give rise to, for example, different views of good care, the character and position of the patient, and leadership in health care organizations--views that sometimes clash intensely.

Suggested Citation

  • Kor Grit & Wilfred Dolfsma, 2002. "The Dynamics of the Dutch Health Care System--A Discourse Analysis," Review of Social Economy, Taylor & Francis Journals, vol. 60(3), pages 377-401.
    • Handle: RePEc:taf:rsocec:v:60:y:2002:i:3:p:377-401
    DOI: 10.1080/0034676021000013377
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    References listed on IDEAS

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    1. Bruno S. Frey, 1997. "Not Just for the Money," Books, Edward Elgar Publishing, number 1183.
    2. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1, June.
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    Cited by:

    1. Moors, Ellen H.M. & Kukk Fischer, Piret & Boon, Wouter P.C. & Schellen, Frank & Negro, Simona O., 2018. "Institutionalisation of markets: The case of personalised cancer medicine in the Netherlands," Technological Forecasting and Social Change, Elsevier, vol. 128(C), pages 133-143.
    2. Dolfsma, W.A. & Finch, J. & McMaster, R., 2004. "Market and Society: How do they relate, and contribute to welfare?," ERIM Report Series Research in Management ERS-2004-105-ORG, Erasmus Research Institute of Management (ERIM), ERIM is the joint research institute of the Rotterdam School of Management, Erasmus University and the Erasmus School of Economics (ESE) at Erasmus University Rotterdam.

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